Comments by Yola Lucire, PhD

ADRs correlate well with genotype. They occur on toxicity as well as on sudden changes up or down. Side effects like suicidality persist well beyond five half lives it takes to clear the drug. Five weeks to 81 days for Prozac. No drug in body. Pill taken 8AM produces different blood level after different periods. And higher levels in reduced metabolisers. Danger periods on starting and fast stopping. Blood levels and doses of two drugs can be normal but they might be synergistic for ADRs. Steady state is a myth. IMs are at greater risk than PMs as side effects creep up unrecognised and are not as dramatic as PMs. Most at risk of suicide or death from intoxication are UMs. They die from prodrugs like Tramadol and oxycodone and from drugs with toxic first metabolites. And respond to nothing.

Yes. It is an international nomenclature. China, upper Mongolia, Iran, Greece and Bosnia all produce population studies. Australian psychiatry is informed by professors funded by pharma and regulators are advised that it is nonsense. President Bush gave it $10 billion and there are huge curated data bases. Obama talked of Precision Medicine in his penultimate State of the Nation address. It gets 1.8 million hits on Google, and hundreds of thousands of hits on Scholar. It is the bedrock of personalised medicine. Craig Venter, Mr Human Genome, pointed out that drug companies do not want doctors knowing it as they make more profits if we don’t know. One size does not fit all. Watch for pharma shills. An eminent Australian psychiatry professsor told me in front of 400 people: I have done two tests and I think pharmacogenetics is nonsense. The test has limited utility unless you know drugs,doses, age, gender and general health of the patient. For forensic purposes. However it flags a possible problem if done before prescribing.

Risperdal (risperidone) is metabolised by cytochrome P450 2D6, known as 2D6. 5-14% of Caucasians have none (defective genes) and up to 40% of central Europeans have one inactive allele to of two so have a diminished rate of metabolism,. All drugs used in psychiatry are metabolized by this system and all patient are different, see any site explaining psychiatric pharmacogenomics.
Furthermore CYP450 2D6 is present at a very low level in young people until their early 20s, so they behave like poor metabolisers (phenotype poor metabolisers) of Risperidal (risperidone). Levels in blood rise and produce toxicity, characteristically akathisia, (50 full text papers on Google scholar) with suicidal and aggressive thoughts and behaviours and toxic hallucinations follow and are inevitable. Toxic side effects are poorly recognized by my psychiatrist colleagues who do not know the difference between toxidromes and mental illnesses.
This is why SSRIs and Zyprexa are such a disaster in kids, and as well their UGTs, (stage 2 metabolism) do not cut in until later, 18 for some. We have published some of this http://www.dovepress.com/antidepressant-induced-akathisia-related-homicides-associated-with-dim-peer-reviewed-article-PGPM We have a paper nearly ready concerning 100 individuals who had no mental illness in existence until they used street drugs or got antidepressants for normal human events, and reacted with toxic side effects. Gene testing for the CYP450s showed they could not metabolize either so instead of getting a safe and slow withdrawal, they got more of the hair of the dog, more drugs metabolized by very enzymes that their adverse reaction showed they could not produce, and most have never left mental health care.
If anyone is interested in pursuing this information please contact me as I have the backing scientific papers.